The Effect Of Neoadjuvant Chemotherapy On Platinum Resistance And Prognosis In Advanced Epithelial Ovarian Cancer

Objective:We aimed to explore the effect of neoadjuvant chemotherapy followed by interval debulking surgery(NACT-IDS)on platinum resistance and prognosis in advanced epithelial ovarian cancer(EOC),to provide more clinical evidence.Methods:We retrospectively reviewed the cases of 162 patients with FIGO stage ?C and ? epithelial ovarian cancer from January 2014 to December 2015 treated at Liaoning Cancer Hospital.According to the treatment methods,the patients were divided into two groups:the NACT-IDS group and PDS group.We evaluated the general characteristics,risk factors of platinum resistance,progression free survival(PFS)and overall survival(OS).Multivariate Logistic regression analysis was performed for the baseline data,clinicopathological factors and platinum resistance.Survival analysis was performed by the Kaplan-Meier method and Log-rank test and Cox proportional hazards modeling.Results:Of 161 patients,112(69.6%)underwent PDS and 49(30.4%)were treated with NACT-IDS.There was no statistically significant difference in age,pathological type,CA125 level before treatment,ascites,and residual tumor diameter between two groups(P>0.05).By the end of follow-up,36 patients(73.5%)in NACT-IDS group and 74 patients(66.1%)in PDS group had relapsed,with no significant difference(P=0.353).Patients with platinum resistance in NACT-IDS group(n=12,24.5%)was more than that in PDS group(n=5,4.5%),with significant difference(P<0.001).The univariate and multivariate analysis proved that NACT and high level of CA125 before treatment were independent risk factor for platinum resistance.Survival analysis showed that there was no significant difference in PFS between NACT-IDS group and PDS group(P>0.05).The average OS in NACT-IDS group was lower than that in PDS group(P=0.023).Univariate and multivariate survival analysis showed that NACT was not an independent risk factor for OS(P=0.348),while ascites and platinum resistance were independent risk factors for OS(P<0.05).Conclusion:NACT and high level of CA125 before treatment increase the risk of platinum resistance in patients with stage ?C and ? EOC,but NACT does not benefit the overall survival of patients.The OS of patients with platinum resistance or ascites significantly decreased.